Analyst, Risk Adjustment

Hi, we're Oscar. We're hiring a Analyst, Risk Adjustment to join our Risk Adjustment team.

Risk Adjustment accounts for differences in members’ health needs and expected cost of care. Accurate and complete clinical documentation helps ensure that a member’s health status is appropriately represented. Prospective Risk Adjustment focuses on proactively supporting opportunities for healthcare providers to review members’ health information and accurately document conditions addressed during clinical care, in accordance with applicable clinical coding and documentation requirements. These efforts may include sharing relevant clinical information with providers at the point of care, conducting virtual or in-home health assessments, and providing reports that identify historical or suspected conditions for provider review and clinical validation.

The Analyst, Risk Adjustment supports the day-to-day execution and performance of Prospective Risk Adjustment programs. This role partners with internal teams and external vendors to ensure operational workflows are functioning as intended, program data and reporting are accurate, claims are processed appropriately, and operational issues are identified and resolved in a timely manner. The analyst will support a portfolio of initiatives including Point-of-Care tools, Virtual Health Assessments (VHA), In-Home Assessments (IHA), and provider reporting to support the review of member conditions. This role is well suited for an analytical, detail-oriented professional interested in developing expertise in Risk Adjustment and healthcare operations.

You will report into the Sr. Manager, Strategic Initiatives (Risk Adjustment).

Work Location: This position is based in our New York, NY office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid

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